Rich countries must stop sucking nurses and doctors away from the poor countries that need them most, declared a recent editorial in The Lancet. Everyone agrees that it’s not a great thing to drain nursing and medical skills from countries where a quarter of adults are infected with a fatal virus that manifests itself though a host of other infectious diseases. But no-one can decide what to do about it.
The Africa Public Health Rights Alliance thinks the answer lies in raising salaries for health workers in African countries. Of course. But couldn’t we also take another approach, raising salaries for nurses in rich countries? Some 13,000 health workers trained in sub-Saharan African countries now practice in Australia, Britain, Canada and the U.S, and there are tens of thousands more from the Philppines, Latin America and the Caribbean.
Those jobs are on offer to immigrants because people at home don’t want to do them. Natives of Manchester don’t want to work awkward hours wiping away sick people’s body fluids for £20,000 a year. Natives of Harare do. Zimbabwe could change that equation by raising salaries to a level close enough to £20,000 a year to remove the incentive for a local nurse to leave an under-resourced hospital in a poorly governed country with chronic health problems. Or Britain could change the equation by raising salaries close enough to a living wage to encourage more Brits to train as nurses, carers and doctors, reducing demand for African staff. Zimbabwe probably can’t afford to do what it needs to do to keep well-trained staff at home. Britain (and Canada and the US) could afford to reduce the demand for overseas staff by making the health industry more attractive to its nationals.